title: Cardiovascular disease risk factors prior to the diagnosis of impaired glucose tolerance and non-insulin-dependent diabetes mellitus in a community of older adults.
abstract: Cardiovascular disease risk factors were measured 10-15 years (mean, 11.9 years) prior to the diagnosis of impaired glucose tolerance and non-insulin-dependent diabetes mellitus in Rancho Bernardo, California. There were 1,847 men and women aged 40-79 years who had no known diabetes or fasting hyperglycemia at baseline (1972-1974). At the follow-up examination (1984-1987), 1,115 men and women (60.4%) had normal glucose tolerance, 513 (27.8%) had impaired glucose tolerance, and 219 (11.9%) had non-insulin-dependent diabetes mellitus as defined by World Health Organization criteria. Rates of impaired glucose tolerance and non-insulin-dependent diabetes mellitus increased with age, and impaired glucose tolerance was approximately twice as common as non-insulin-dependent diabetes mellitus. Those with non-insulin-dependent diabetes mellitus were older and more overweight and had higher levels of blood pressure, fasting plasma glucose, and triglyceride at baseline than those whose glucose tolerance remained normal; those with impaired glucose tolerance generally had intermediate levels of the same risk factors. When it was examined in a prospective fashion, in general, the age-adjusted risk of non-insulin-dependent diabetes mellitus increased with increasing quartile of each risk factor, and the risk of non-insulin-dependent diabetes mellitus in a given quartile was greater than that for impaired glucose tolerance. Logistic regression analyses showed these factors to be positively associated with a subsequent diagnosis of impaired glucose tolerance as well as non-insulin-dependent diabetes mellitus in women, and to a lesser degree in men, independent of baseline age and body mass index (weight (kg)/height (m)2). These data illustrate that a less favorable cardiovascular risk factor profile precedes the diagnosis of both non-insulin-dependent diabetes mellitus and impaired glucose tolerance.
authors.affiliation: Department of Community and Family Medicine, School of Medicine, University of California, San Diego, La Jolla 92093.
authors.forename: J B
authors.initials: JB
authors.lastname: McPhillips
authors.forename: E
authors.initials: E
authors.lastname: Barrett-Connor
authors.forename: D L
authors.initials: DL
authors.lastname: Wingard
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000378:metabolism; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002140:California; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol